Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment

Gross, Anita; Langevin, Pierre; Burnie, Stephen J; Bédard-Brochu, M.-S.; Empey, Brian; Dugas, Estelle; Faber-Dobrescu, Michael; Andres, C.; Graham, Nadine; Goldsmith, Charles H.; Brønfort, Gert; Hoving, Jan L.; Leblanc, F.

doi:10.1002/14651858.cd004249.pub4

Cited by 158 publications

(164 citation statements)

References 189 publications

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“…4. Reeducation of correct movement patterns within the spine, especially at the border of the cervical and thoracic segments (rotational movements), through targeted exercises of different degrees of complexity, and in the shoulder girdle [41][42][43][44][45][46][47].…”

Section: Physiotherapeutic Strategymentioning

confidence: 99%

Recommendations of the Polish Society of Physiotherapy, the Polish Society of Family Medicine and the College of Family Physicians in Poland in the field of physiotherapy of back pain syndromes in primary health care

Kassolik¹,

Rajkowska-Labon²,

Tomasik³

et al. 2017

fmpcr

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4 college of Family Physicians in Poland 5 department of Family medicine, chair of internal diseases and gerontology, jagiellonian university medical college in krakow, Poland 6 academy of Physical Education in katowice, Poland 7 Polish society of Family medicine, Poland 8 department of Family medicine, wroclaw medical university, Poland A -study design, B -data collection, C -statistical analysis, D -data interpretation, E -manuscript Preparation, F -literature search, G -Funds collection the purpose of these guidelines is to attract attention to the need for systemic corrections in the existing health care model to become an effective tool for improving health. the intention of the authors is to present the assumptions of a new approach of physiotherapeutic treatment standards for patients with motor disorders in back pain syndromes: cervical, thoracic and lumbar--sacral, at the primary health care level. the current management provides care for this group of primary care patients mainly through pharmacotherapy and/or by referring them to an appropriate specialist outpatient clinic. in the latter situation, the waiting time from the appearance of pain to first contact with the physiotherapist in Poland is several months. in many patients, the symptoms of back pain are uncomplicated and require a few simple low-cost physiotherapeutic procedures (massage, simple physical therapy and kinesis therapy). in such cases, physiotherapeutic treatment should be based on the simple assessment of the patient's condition and planning therapy on this basis. this can be achieved by performing a functional examination and palpation assessment to determine which muscles and ligaments are responsible for pain. this evaluation provides a basis for establishing a physiotherapeutic strategy based on massage, physical therapy and kinesitherapy. in addition, simple instruction on self-massage, self-physiotherapy and self--kinesitherapy should be provided, as well as the need for orthotic supplies and other technical assistance ought to be considered. the potential effects of such a form of primary care activation include: increase of the possibility to have influence, using directed simple physical factors, on a particular motion system disorder by the patient himself/herself, support of the rehabilitation process performed by a physiotherapist in the primary care and specialist outpatient clinic setting and shaping conscious pro-health attitudes in primary care patients. Key words: primary care physician, physiotherapy, back pain syndromes. Summary

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Section: Physiotherapeutic Strategymentioning

confidence: 99%

Recommendations of the Polish Society of Physiotherapy, the Polish Society of Family Medicine and the College of Family Physicians in Poland in the field of physiotherapy of back pain syndromes in primary health care

Kassolik¹,

Rajkowska-Labon²,

Tomasik³

et al. 2017

fmpcr

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“…Third, MTU was only compared to PT, whereas recent evidence indicates that a combination of manual therapy and PT is most likely to be effective [19]. As economic evaluations are sparse in the field of manual therapy [20] and evidence regarding the relative cost-effectiveness of a combination of manual therapy and PT versus an alternative strategy is lacking, future research into this topic is warranted. …”

Section: Interpretation Of the Findingsmentioning

confidence: 99%

Cost-effectiveness of manual therapy versus physiotherapy in patients with sub-acute and chronic neck pain: a randomised controlled trial

et al. 2016

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Purpose To evaluate the cost-effectiveness of manual therapy according to the Utrecht School (MTU) in comparison with physiotherapy (PT) in sub-acute and chronic non-specific neck pain patients from a societal perspective. Methods An economic evaluation was conducted alongside a 52-week randomized controlled trial, in which 90 patients were randomized to the MTU group and 91 to the PT group. Clinical outcomes included perceived recovery (yes/no), functional status (continuous and yes/no), and quality-adjusted life-years (QALYs). Costs were measured from a societal perspective using self-reported questionnaires. Missing data were imputed using multiple imputation. To estimate statistical uncertainty, bootstrapping techniques were used.Results After 52 weeks, there were no significant between-group differences in clinical outcomes. During follow-up, intervention costs (b:€-32; 95 %CI: -54 to -10) and healthcare costs (b:€-126; 95 %CI: -235 to -32) were significantly lower in the MTU group than in the PT group, whereas unpaid productivity costs were significantly higher (b:€186; 95 %CI:19-557). Societal costs did not significantly differ between groups (b: €-96; 95 %CI:-1975 95 %CI:- -2022. For QALYs and functional status (yes/no), the maximum probability of MTU being costeffective in comparison with PT was low (B0.54). For perceived recovery (yes/no) and functional status (continuous), a large amount of money must be paid per additional unit of effect to reach a reasonable probability of costeffectiveness. J (2016J ( ) 25:2087J ( -2096J ( DOI 10.1007 Conclusions From a societal perspective, MTU was not cost-effective in comparison with PT in patients with subacute and chronic non-specific neck pain for perceived recovery, functional status, and QALYs. As no clear total societal cost and effect differences were found between MTU and PT, the decision about what intervention to administer, reimburse, and/or implement can be based on the preferences of the patient and the decision-maker at hand. Trial registration ClinicalTrials.gov Identifier: NCT00713843Eur Spine

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“…The majority of available trials have evaluated the short-and long-term efficacy of surgical approaches (anterior cervical diskectomy, cervical disk arthroplasty, and posterior decompression),13,14 manipulations,15 physical therapies and exercise,16 acupuncture,17 and cognitive behavioral therapy 18. Therefore, most guidelines are focused on nonpharmacological treatment of neck pain,19 while the only published recommendations on the pharmacological approach are based on expert opinion, with some evidence being extrapolated from clinical trials of analgesic drugs for back pain or other musculoskeletal diseases 20.…”

Section: Introductionmentioning

confidence: 99%

Tapentadol extended release for the management of chronic neck pain

Billeci¹,

Coluzzi²

2017

JPR

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BackgroundThe role of opioids in the management of chronic neck pain is still poorly investigated. No data are available on tapentadol extended release (ER). In this article, we present 54 patients with moderate-to-severe chronic neck pain treated with tapentadol ER.Patients and methodsPatients received tapentadol ER 100 mg/day; dosage was then adjusted according to clinical needs. The following parameters were recorded: pain; Douleur Neuropathique 4 score; Neck Disability Index score; range of motion; pain-associated sleep interference; quality of life (Short Form [36] Health Survey); Patient Global Impression of Change (PGIC); Clinician GIC; opioid-related adverse effects; and need for other analgesics.ResultsA total of 44 of 54 patients completed the 12-week observation. Tapentadol ER daily doses increased from 100 mg/day to a mean (standard deviation) dosage of 204.5 (102.8) mg/day at the final evaluation. Mean pain intensity at movement significantly decreased from baseline (8.1 [1.1]) to all time points (P<0.01). At baseline, 70% of patients presented a positive neuropathic component. This percentage dropped to 23% after 12 weeks. Tapentadol improved Neck Disability Index scores from 55.6 (18.6) at baseline to 19.7 (20.9) at the final evaluation (P<0.01). Tapentadol significantly improved neck range of motion in all three planes of motion, particularly in lateral flexion. Quality of life significantly improved in all Short Form (36) Health Survey subscales (P<0.01) and in both physical and mental status (P<0.01). Based on PGIC results, approximately 90% of patients rated their overall condition as much/very much improved. Tapentadol was well tolerated: no patients discontinued due to side effects. The use of other analgesics was reduced during the observed period.ConclusionOur results suggest that tapentadol ER, started at 100 mg/day, is effective and well tolerated in patients with moderate-to-severe chronic neck pain, including opioid-naïve subjects. Patients can expect a decrease in pain, an improvement in neck function, and a decrease in neuropathic symptoms.

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Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment

Cited by 158 publications

References 189 publications

Recommendations of the Polish Society of Physiotherapy, the Polish Society of Family Medicine and the College of Family Physicians in Poland in the field of physiotherapy of back pain syndromes in primary health care

Recommendations of the Polish Society of Physiotherapy, the Polish Society of Family Medicine and the College of Family Physicians in Poland in the field of physiotherapy of back pain syndromes in primary health care

Cost-effectiveness of manual therapy versus physiotherapy in patients with sub-acute and chronic neck pain: a randomised controlled trial

Tapentadol extended release for the management of chronic neck pain

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